Lump sum compensation for permanent impairment

If you (the worker) have a permanent impairment as a result of a work related injury or illness, you may be entitled to receive a lump sum payment as compensation.

This is in addition to weekly payments, medical and related expenses that may generally be available through the workers compensation system.

The information below is generalised and the payments you receive may vary based on your circumstances.

Eligibility

Claims for lump sum compensation for injuries that occurred on and from 1 January 2002 are based on an assessment of your permanent impairment.

If your claim for lump sum compensation was made on or after 19 June 2012, then you must have 11 per cent or more permanent impairment for a physical injury or 15 per cent or more for a primary psychological injury to be entitled to receive permanent impairment compensation. No permanent impairment compensation is available for secondary psychological injuries.

Only one claim for permanent impairment compensation can be made in respect of the injury. However, if you made a claim for permanent impairment before 19 June 2012, you may be entitled to make one further lump sum compensation claim if your condition has deteriorated.

Assessment of permanent impairment

To undergo an assessment, your injury must have reached maximum medical improvement. This means your condition has stabilised and is unlikely to change substantially in the next year with or without treatment. If you are unsure if you have reached maximum medical improvement, speak with your treating doctor or specialist.

Making a claim

A permanent impairment claim form is required unless your claim for weekly and other benefits has already included a claim for lump sum compensation for permanent impairment. The form provides details of the information that must be supplied when making a claim.

The insurer’s role in determining liability

Once the insurer has received the claim for lump sum compensation for permanent impairment, then within one month the insurer must either accept liability and make a reasonable offer of settlement, or dispute liability.

This timeframe can be extended if the insurer determines that all the relevant information has not been provided about the claim. In that case the insurer must, within two weeks of receiving the claim:

ask you to supply this information, and/or

make arrangements for a permanent impairment assessor to examine you.

If the insurer requires this further information, they have two months after you have provided all relevant information, or attended the medical examination, to make an offer of settlement or dispute liability.

Complying agreement/making a settlement offer

A complying agreement is a written agreement between you and the insurer regarding the assessed level of permanent impairment. This assessed level may result in a lump sum payment for permanent impairment being made to you.

Before entering into the agreement about the assessed permanent impairment, the insurer must be satisfied that you have either obtained independent legal advice or have waived the right to independent legal advice.

The insurer is required to record evidence that this advice has been obtained, or that you have chosen not to obtain it, in the details of the agreement.